A 41-year-old woman with a diagnosis of Kyrle disease (KD) and multitherapy-resistant hidradenitis suppurativa (HS) was referred for evaluation after having been unsuccessfully treated with oral retinoids (isotretinoin 0.5 mg/Kg/die for 6 months), and several cycles of antibiotics (clindamycin, rifampin, tetracycline). She had KD and HS since the age of 38 and 35 years, respectively, was a heavy tobacco smoker (20 cigarettes daily), and had a medical history of acne and rheumatoid arthritis (Charlson Comorbidity Index, CCI, score 0). An eventual familiarity for HS was not referred. The clinical examination showed numerous hyperpigmented, itchy, follicular keratotic papulo-nodular lesions on her upper and lower limbs related to the KD.